Confusion over advice on alcohol for pregnant women

Pregnant women face more confusion about the safety of drinking alcohol after draft guidelines published yesterday suggested a glass a day does no harm.

The draft from the government's standards-setting body, the National Institute for Healthcare and Clinical Excellence (Nice), runs directly counter to official government advice. In May, the Department of Health urged women to abstain completely from alcohol during pregnancy.

But Nice's preliminary recommendation on antenatal care - now out to consultation - says that pregnant women should limit their intake to "less than one standard drink (1.5 units or 12g of alcohol) per day and if possible avoid alcohol in the first three months of pregnancy". It says women should be told that binge drinking can be harmful to the foetus.

In practice, this would mean the green light for women to drink one small glass of wine a day, or half a pint of 5% lager or strong cider, or a bottle of alcopop.

A spokesperson for Nice said their experts had carried out a systematic review of the evidence, concluding "that there is no consistent evidence of adverse effects from low to moderate alcohol use during pregnancy but the evidence is probably not strong enough to rule out any risk". The recommendations are subject to consultation and final guidance is due to be published in March 2008.

In May, acting on advice from England's chief medical officer, Sir Liam Donaldson, the department said it was best for women to avoid alcohol completely during pregnancy. "Our guidance is still what the CMO said - it is best to avoid it entirely," said a spokesperson.

The National Childbirth Trust backed the Department of Health advice, while warning that women should not be made to feel guilty."Pregnant women who have a few drinks often worry a great deal about whether they have harmed their baby," said chief executive Belinda Phipps. "On balance, it is believed that if a light, infrequent drinker, in general good health, drinks to the point of drunkenness on one occasion, the risk to her baby is small."

Pat O'Brien, a consultant obstetrician at University College London, said he thought the Department of Health's advice was based on potential damage to the whole population rather than the individual. "There was some evidence at that time that some women were drinking more than the recommended allowance. They took that stance because they felt that in population terms it was the best way of deterring women from drinking too much in pregnancy."